Emerging carbapenem resistance in Gram-negative pathogens threatens to further limit antibiotic treatment options1,2

Key resistance facts for high-priority pathogens


Metallo-β-lactamases (MBLs) are on the rise3

  • In 2021, 20.4% of CRE infections in the US were caused by MBL-producing isolates vs ~4% in 2019a

Pseudomonas aeruginosa

Exhibits intrinsic and adaptive resistance4

  • Mechanisms include the overexpression of efflux pump MexAB-OprM, AmpC, and deleted porin channel OprD

Acinetobacter baumannii

Co-infection threat5,6

  • 1 out of every 3 to 5 A baumannii complex infections is polymicrobial, often with other Gram-negative pathogens
  • A baumannii may protect co-infecting pathogens from carbapenem therapy

Stenotrophomonas maltophilia

Intrinsic β-lactam resistance via MBL7

  • Chromosomally encoded metallo-β-lactamase (L1) and serine cephalosporinase (L2) confer resistance to β-lactams and carbapenems
Based on a surveillance study that included 27,834 Enterobacterales isolates collected from 74 US medical centers in 2019-2021.3
CRE=carbapenem-resistant Enterobacterales.

Carbapenem non-susceptible pathogen distribution8

The most prevalent carbapenem-non-susceptible pathogens seen in US inpatients are Pseudomonas spp, 38%; Stenotrophomonas maltophilia, 31%; Enterobacterales, 21% and Acinetobacter spp, 9%; Other, 1%

Based on the Premier Healthcare Database: Adult, non-cystic fibrosis patients in the inpatient setting treated with antibiotics from 2021 and 2022 with carbapenem non-susceptible Gram-negative pathogen cultures.

Frequency of carbapenem-resistant (CR) Enterobacterales isolates producing MBLs in the US3

Metallo-β-lactamases (MBLs) are on the rise. In 2021, 20.4% of carbapenem-resistant Enterobacterales (CRE) infections were caused by MBL-producing isolates vs ~4% in 2019

Based on 27,834 Enterobacterales isolates collected from 74 US medical centers in 2019-2021. CRE (n=261) were screened for carbapenemase (CPE) genes by whole-genome sequencing.

Carbapenem resistance in Gram-negative pathogens requires a thoughtful antimicrobial approach1,2